Recent advances in the diagnosis and management of tuberculous meningitis.

<h4>Purpose</h4> <p>Tuberculous meningitis is a devastating infection that is hard to diagnose and treat. We have reviewed tuberculous meningitis original research published within the last 18 months, selecting papers which we consider have most advanced knowledge. </p> <...

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Main Authors: Mai, N, Thwaites, G
Format: Journal article
Sprog:English
Udgivet: Lippincott, Williams & Wilkins 2016
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author Mai, N
Thwaites, G
author_facet Mai, N
Thwaites, G
author_sort Mai, N
collection OXFORD
description <h4>Purpose</h4> <p>Tuberculous meningitis is a devastating infection that is hard to diagnose and treat. We have reviewed tuberculous meningitis original research published within the last 18 months, selecting papers which we consider have most advanced knowledge. </p> <h4>Recent findings</h4> <p>We review advances in diagnostic methods, anti-tuberculosis chemotherapy, and the common complications of tuberculous meningitis. New commercial molecular diagnostic tests, such as GeneXpert MTB/RIF, have an important role in tuberculous meningitis diagnosis, but as with all other available tests they lack sensitivity and cannot rule out the disease. Recent trials and pharmacokinetic studies have advanced understanding of the best anti-tuberculosis drug regimens for tuberculous meningitis, although optimal doses and duration remain uncertain, especially for young children. Good outcomes depend upon the careful management of the common complications (brain infarcts, tuberculomas, hydrocephalus and hyponatraemia) and controlling intracranial pressure. New tools, such as point-of-care ultrasound, may assist in the management, especially in the assessment of intravascular volume and raised intracranial pressure.</p> <h4>Summary</h4> <p>Disability-free survival from tuberculous meningitis depends upon rapid diagnosis, starting anti-tuberculosis drugs before the onset of coma, and managing complications. Progress is slow and threatened by emerging drug resistant bacteria, but new drugs and diagnostic technologies offer hope to future patients.</p>
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spelling oxford-uuid:88fdeed5-69da-4fb8-8d66-d4ebbd7c689e2022-03-26T22:21:26ZRecent advances in the diagnosis and management of tuberculous meningitis.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:88fdeed5-69da-4fb8-8d66-d4ebbd7c689eEnglishSymplectic Elements at OxfordLippincott, Williams & Wilkins2016Mai, NThwaites, G <h4>Purpose</h4> <p>Tuberculous meningitis is a devastating infection that is hard to diagnose and treat. We have reviewed tuberculous meningitis original research published within the last 18 months, selecting papers which we consider have most advanced knowledge. </p> <h4>Recent findings</h4> <p>We review advances in diagnostic methods, anti-tuberculosis chemotherapy, and the common complications of tuberculous meningitis. New commercial molecular diagnostic tests, such as GeneXpert MTB/RIF, have an important role in tuberculous meningitis diagnosis, but as with all other available tests they lack sensitivity and cannot rule out the disease. Recent trials and pharmacokinetic studies have advanced understanding of the best anti-tuberculosis drug regimens for tuberculous meningitis, although optimal doses and duration remain uncertain, especially for young children. Good outcomes depend upon the careful management of the common complications (brain infarcts, tuberculomas, hydrocephalus and hyponatraemia) and controlling intracranial pressure. New tools, such as point-of-care ultrasound, may assist in the management, especially in the assessment of intravascular volume and raised intracranial pressure.</p> <h4>Summary</h4> <p>Disability-free survival from tuberculous meningitis depends upon rapid diagnosis, starting anti-tuberculosis drugs before the onset of coma, and managing complications. Progress is slow and threatened by emerging drug resistant bacteria, but new drugs and diagnostic technologies offer hope to future patients.</p>
spellingShingle Mai, N
Thwaites, G
Recent advances in the diagnosis and management of tuberculous meningitis.
title Recent advances in the diagnosis and management of tuberculous meningitis.
title_full Recent advances in the diagnosis and management of tuberculous meningitis.
title_fullStr Recent advances in the diagnosis and management of tuberculous meningitis.
title_full_unstemmed Recent advances in the diagnosis and management of tuberculous meningitis.
title_short Recent advances in the diagnosis and management of tuberculous meningitis.
title_sort recent advances in the diagnosis and management of tuberculous meningitis
work_keys_str_mv AT main recentadvancesinthediagnosisandmanagementoftuberculousmeningitis
AT thwaitesg recentadvancesinthediagnosisandmanagementoftuberculousmeningitis